24^th Annual World Congress on Pediatrics August 10-11, 2023 Vancouver, Canada

Biography:

Dr. Peter Averkiou is a pediatrician and an Associate Professor of Pediatrics at the Charles E. Schmidt College of Medicine at Florida Atlantic University. He is the Co-Director of the four Foundations of Medicine Courses, the Director of the Service Learning Projects, the Director of the Newborn Nursery Clinical Rotation and the Director of the Synthesis and Transition Course at the medical school.

Abstract:

The Newborn Nursery Clinical Experience is an innovative, early exposure for medical students to the hospital setting and family medicine. Early in their second year, our medical students are immersed into the Newborn Nursery, while also experiencing the neonatal intensive care unit (NICU) and attending obstetrical deliveries. They witness, first hand, the interprofessional and interdisciplinary workings of pediatricians, obstetricians, neonatologists, anesthesiologists, nurses and other professionals. The medical students are also instructed on how to read a medical chart and on proper medical documentation and its importance. They also interact with the mother of the patient, as well as other family members that are in attendance, and long-term continuity of integrated care and the focus on the personal patient/patient’s guardian(s) - physician relationship is stressed. This experience is always well-received and highly evaluated by our medical students. It also helps to prepare them for their third-year clinical rotations in family medicine, pediatrics and Ob/Gyn.

Biography:

As an academic neonatologist and pediatric intensive care physician, Dr. Tsao work in neonatal and pediatric intensive care, congenital airway anomalies, newborn screening. Dr. Tsao’s current research interests include i) universal newborn screening program of critical congenital heart disease, congenital CMV infection, and congenital toxoplamosis, ii) diagnosis and therapeutic intervention of airway anomalies via flexible bronchoscopy, iii) underlying mechanism and management of pediatric ARDS and HIE, and iv) long-term outcomes of high-risk infants.

Abstract:

Introduction: Studies on risk factors for childhood hearing deficit (HD) are usually based on questionnaires or small sample sizes. Therefore we conducted a nationwide population-based case–control study to comprehensively analyze the maternal, perinatal, and postnatal risk factors for HD in full-term children.

Methods: We retrieved data from three nationwide databases related to maternal characteristics, perinatal comorbidities, and postnatal characteristics and adverse events. We used 1:5 propensity score matching to include 12,873 full-term children with HD and 64,365 age-, sex-, and enrolled year-matched controls. Conditional logistic regression was used to evaluate the risk factors for HD.

Results: Among the various maternal factors, maternal HD (adjusted odds ratio [aOR]: 8.09, 95% confidence interval [95%CI]: 7.16–9.16) and type 1 diabetes (aOR: 3.79, 95%CI: 1.98–7.24) had the highest odds of childhood hearing impairment. The major perinatal risk factors for childhood hearing impairment included ear malformations (aOR: 58.78, 95%CI: 37.5–92.0) and chromosomal anomalies (aOR: 6.70, 95%CI: 5.25–8.55), and the major postnatal risk factors included meningitis (aOR: 2.08, 95%CI: 1.18–3.67) and seizure (aOR: 3.71, 95%CI: 2.88–4.77). Other factors included acute otitis media, postnatal ototoxic drug use, and congenital infections.

Conclusions: Many risk factors for childhood HD identified in our study are preventable, such as congenital infection, meningitis, ototoxic drug use, and some maternal comorbidities. Accordingly, more effort is required to prevent and control the severity of maternal comorbidities during pregnancy, initiate genetic diagnostic evaluation for high-risk children, and aggressive screening for neonatal infections.  

Biography:

Sarvin Sajedianfard graduated from Shiraz University of Medical Sciences. She is working at oncology center in Shiraz, Iran as a pediatrician for 2 years.

Abstract:

Background and objectives: Wilson’s disease (WD) is a genetic disorder of liver affecting copper metabolism and is one of the common causes of liver failure. In this study we aimed to test the diagnostic value of a questionnaire for the diagnosis of WD in pediatrics age group.

Materials and Methods: Two groups of 70 children with the diagnosis of WD and 70 without WD were included in the study. The gold standard test for the diagnosis of WD was liver biopsy. Then a modified questionnaire with 4 items was used and the results were compared to the definite diagnosis made by pathology.

Results: The median (IQR) modified score in those with WD was significantly higher than that for the comparison group. The sensitivity and specificity were 100% and 98.6%, respectively, according to an NPV of 100%.

Conclusion: As WD is one of the causes of liver transplant, this modifies scoring system helps to diagnosis of WD in children especially in regions with limited access to specific laboratory tests for the diagnosis of WD.

Biography:

School of Medicine, China Medical University, Taiwan. 1993, M.D. Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, Pediatric Residency 1999. Research fellowship, Division of Infectious Diseases, National Health Research Institute, Taipei, Taiwan 2001. Research fellowship, Division of Pediatric Infectious Diseases, Children Hospital Boston, MA, USA 2007. Research fellowship, School of Medicine, Harvard University, MA, USA 2007. Associate Professor, School of Medicine, National Yang Ming University, Taipei, Taiwan 2016. Professor, School of Medicine, National Yang Ming University, Taipei, Taiwan 2023. Lately, I conducted several studies and published several SCI literatures in the field of ESBL E. coli infection in children, adults as well as environment and community carriage, such as the article Extended-spectrum β-lactamase-producing Escherichia coli bacteremia: comparison of pediatric and adult populations in  J Microbiol Immunol Infect. In 2018. Bloodstream Infection with Extended-spectrum Beta-lactamase–producing Escherichia coli: the role of virulence genes in J Microbiol Immunol Infect. In 2019. Prevalence and Risk Factors for Colonization by Extended-spectrum β-lactamase-producing or ST 131 Escherichia coli among Asymptomatic Adults in Community Settings in Southern Taiwan in Infection and Drug Resistance in 2019. Prevalence and Household Risk Factors for Fecal Carriage of ESBL-Producing, Sequence Type 131, and Extraintestinal Pathogenic Escherichia coli among Children in Southern Taiwan in  J Microbiol Immunol Infect, and Distribution and Genomic Characterization of Third Generation Cephalosporin Resistant Escherichia coli Isolated From a Single Family and Home Environment: A 2-Year Longitudinal Study in Antibiotics in August, 2022. Published and/ or presented over 70 abstracts and peer reviewed publications.

Abstract:

Background: Broad-spectrum drug-resistant (defined as resistant to 3rd generation of cephalosporines or new quinolones) Escherichia coli (E. coli), particularly clonal group sequence type 131 (ST131) that produce CTX-M types of extended-spectrum beta-lactamase (ESBL)-producing E. coli have dramatically increased worldwide. In our prior studies, we found that the prevalence of community-onset ESBLproducing E. coli UTIs among infants was similar in urban and rural populations in southern Taiwan. We also found in that study that most infants with UTIs were previously healthy with no apparent risk factors. The increase of ESBL-producing E. coli infections may be related to the infection by asymptomatic carriers or environmental circulation of ESBL-containing microorganisms. However, the distributions of resistant E. coli in households in different geographic regions of Taiwan are still unknown. Additional prospective multicenter studies are required to investigate the prevalence of community-onset E. coli infections in different geographic regions. Methods: E. coli isolates from the stool of children with uropathogenic or fecal carriage of BDR E. coli and their families and from their household environments were prospectively identified in different regions of Taiwan. The E. coli isolates identified as BDR were tested for ESBL, and multilocus sequence typing (MLST) was used to detect ST131. Fecal shedding duration of different regions was compared. Purpose: This study investigated the prevalence of BDR E. coli, particularly for ST131 and ESBL-producing strains, in human carriage, the environment, and households and the duration of shedding of BDR E. coli in different geographical regions of Taiwan.

Biography:

Kumars Pourrostami, Department of Pediatrics, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran

Abstract:

Human astroviruses (HAstVs) have frequently been detected in individuals with acute gastroenteritis (AGE). However, a precise estimate of the overall prevalence of the virus in children with AGE as well as the possible association of the virus with gastrointestinal complications is not available up to now. The present study estimated the overall prevalence of HAstVs in children with gastrointestinal complications as well as the association between the virus and symptoms. We systematically searched four international databases (PubMed, Scopus, Web of Science, and Google scholar) to find studies on the prevalence of HAstVs in people with AGE published between Jan 2000 and Sep 2021. Analysis of the 223 included studies presented a 4.2% (95% CI 3.8%–4.8%) prevalence of the virus in AGE individuals. Based on case‐control studies, a significant association between these viruses and AGE was detected (OR: 2.059, 95% CI; 1.438–2.949). HAstV‐1 and HAstV‐VA‐2 is the most and least common genotypes in the AGE patients, respectively (59.0%, 95% CI: 52.1%–65.6% vs. 4.9%, 95% CI: 2.6%–9.1%). Due to the statistically significant association between HAstV and gastrointestinal complications, more attention should be paid to these viruses in people with AGE and more studies should employ case‐control design.

Biography:

Abstract:

Back ground: Birth Asphyxia is one of the leading causes of neonatal and perinatal mortality in developing Asian Countries. Quick and safe neonatal resuscitation takes on priority in saving lives discovered for the first time in the world. Newly born resuscitation is unique in that displacement of lung filled fetal fluid requires continuous distending pressure as opposed to intermittent positive pressure ventilation is both scientifically and physiologically proven for uniform recruitment of alveoli and functional residual capacity to achieve optimal gas exchange. Aim: The only therapy for hypoxia is oxygen reducing Pulmonary Vascular Resistance (PVR) initiates breathing and reflex physiological mechanism of left to right shunting promotes vital cardio-vascular changes adapting to extra-uterine life. Method: Study comprised of 1,383 consecutive singleton live births during 14-month period from 1^st April 2016 to 31^st May 2017, I attended 830 cases among 1383 deliveries and exclusion criteria were 12 twin pregnancies and 10 stillbirths. Methodology includes three steps. Step one is Pulse oximetry score from zero to +5 based on peripheral oxygen saturation. Step two is classification of newborns into Grade I to V based on SpO₂, pattern of respiration, rate/min and heart rate (bpm) and step three is Lalana Newborn Resuscitation (LNR) Protocol I and II by Continous positive pressure ventilation by sustained nasal oxygen inflation. Results: Incidence of birth asphyxia was 21.4%, all 178 hypoxic/asphyxiated newly borns Graded I-V within 20-120 seconds of birth, were successfully resuscitated by sustained nasal oxygen inflation at flow rate of 4-15 Liters/minute directed towards baby’s nostrils through a wide bore tube for up to 1 to 3 minutes, initiating rhythmic respiration, rate 30-60/min, heart rate 120-160 beats per minute (bpm) and SpO₂>96% monitored continuously by Pulse Oximeter. Conclusion: ‘Lalana Newborn Resuscitation’ (LNR) proved effective in all 178 asphyxiated newborns, Grade I-V by continuous positive pressure ventilation with sustained nasal oxygen inflation at flow rates of 4-15 L/min who commenced rhythmic breathing within 1-3 minutes of birth, respiratory rate 30-60/min, heart rate 120-160 bpm and Zero pulse oximetry score, SpO₂ >96%.

Biography:

Marfel Coleen P. Vergara is a pediatrician from National Children’s Hospital, Philippines. She received a bachelor’s degree in cell and molecular biology from University of the Philippines, and finished Doctor of Medicine program at St. Luke’s Medical Center College of Medicine in Metro Manila, Philippines. She is currently in the Department of Health, serving a local hospital to help the needs and improve the health and wellbeing of the poor Filipino children. 

Abstract:

RATIONALE: Invasive candidiasis is a serious condition that occur more commonly in vulnerable populations, such as in preterm neonates especially those in intensive care units. Antifungal prophylaxis has been suggested to decrease mortality in this vulnerable population, with fluconazole as the drug of choice because of its ability to treat more than 90% of Candida species isolates. OBJECTIVE: To determine the efficacy and safety of fluconazole in preventing invasive candidiasis in preterm infants. METHODOLOGY: Publications were searched through PubMed, Cochrane, HERDIN plus, Google Scholar, ResearchGate, ClinicalTrials.gov, medRxiv, Epistemonikos, WHO International Clinical Trials Registry, and ALIBATA, without language restriction. Randomized controlled trials that compared the effect of prophylactic oral or systemic fluconazole versus placebo in preterm infants, done from January 2000 until present, were included. The methodological quality of the studies were assessed based on the (1) randomization process, (2) deviations from intended interventions, (3) missing outcome data, (4) measurement of the outcome, and (5) selection of the reported result, and a meta-analysis was conducted using STATA. RESULTS: A total of 5 studies were included, with a total of 1084 preterm infants. Prophylactic fluconazole significantly reduced the incidence of invasive candidiasis by 60% (RR=0.40; 95% CI: 0.21, 0.77; p=0.006). The incidence of mortality (RR=0.84; 95% CI: 0.6, 1.2; p=0.324) and necrotizing enterocolitis (RR=0.94; 95% CI: 0.61, 1.44; p=0.770) did not increase among infants give fluconazole prophylaxis as compared to placebo. Fluconazole prophylaxis resulted to a higher mean length of hospital stay versus placebo (SMD=0.16; 95% CI: 0.02, 0.30; p=0.022). Decrease in the incidence of IC also did not depend on the age at first dosage, whether given at 72nd or 120th hour of life (p=0.047, p=0.035), or the dosage used, whether given at 3mg/kg or 6mg/kg (p=0.0043, p=0.0002). CONCLUSION: The use of prophylactic fluconazole decrease invasive fungal infection in preterm infants. While there is no noted increase in mortality and adverse effects, larger clinical trials with longer follow-up periods are still recommended to comprehensively assess the safety profile of fluconazole prophylaxis among preterm infants.

Biography:

Gizachew Gobebo Mekebo (Assistant Professor of Biostatistics), Department of Statistics, Ambo University, Ambo, Oromia Regional State, Ethiopia

Abstract:

Background: Low birth weight (LBW) is a good summary measure of multifaceted public health problems including long-term maternal malnutrition, ill health, and poor health care during pregnancy. LBW results in a higher risk of dying in the first 28 days of life (neonatal death). LBW is a global public health problem with higher prevalence in developing countries. The prevalence of LBW in Ethiopia remains high. In Ethiopia, Oroma is one of the regions with high prevalence of LBW. This study aimed to determine prevalence of LBW and identify factors associated with LBW among under-five children (U5C) in Oromia regional state of Ethiopia. Methods: The data used in this study were extracted from the 2016 Ethiopian Demographic and Health Survey data. A multivariable logistic regression analysis was done to identify the potential predictors of LBW. An adjusted odds ratio with a 95% confidence interval was used examine associated of factors with LBW in multiple logistic regression analysis. Results: A total of 137 women of U5C were considered in this study. The prevalence of LBW in the study area was 15.3% (95% CI: 9.7-22.5). Rural residence (AOR:3.927, 95% CI: 1.104-14.676), females (AOR:3.058, 95% CI: 1.008-11.140) and multiple births (AOR:4.655, 95% CI: 2.557-15.644) were significantly associated with higher odds of being LBW babies while secondary and higher education (AOR:0.220, 95% CI: 0.056-0.861), being supplied iron during pregnancy (AOR:0.362, 95% CI: 0.105-0.781), ANC attendance (AOR:0.473, 95% CI: 0.203-0.614) and gestational age of 37 weeks and above (AOR:0.224, 95% CI: 0.312-0.811) were significantly associated with lower odds of being LBW babies. Conclusion: Place of residence, sex of child, maternal education, ANC visits, iron supplementation, birth type and gestational age were statistically significant factors associated with LBW. Thus, health care providers should encourage mothers to give attention to attend ANC services. Mothers should also be encouraged to get iron during their pregnancies. Furthermore, there should be preventive strategies for preterm delivery.